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HMO AUDITS: Wilson Signs Two Bills For Better Oversight

Gov. Pete Wilson yesterday signed two bills into law that his office said would improve the auditing of HMOs and other health care providers. AB 1959, sponsored by state Assemblyman Martin Gallegos (D-Baldwin Park), requires the state Department of Corporations to convene a working group for the purpose of developing standards for quality audits of managed health care plans. "Throughout my administration, I have sought to make managed care more user-friendly for Californians," said Wilson. "This bill is a significant step toward that end." The bill also requires the task force to recommend ways to reduce duplication of audits, develop a core set of health care quality standards for HMOs, recommend data collection methods and processes that improve the coordination of quality audits and determine a process for releasing audits to the public.

Two Birds With One StoneAB 162, sponsored by state Assemblywoman Barbara Alby (R-Sacramento), requires the state corporations department and state Department of Health Services to coordinate the audits and surveys of physician offices already required under the Medi-Cal Act or the Knox-Keene Act. "The time and money that California spends on competing and duplicative audits would be better spent providing actual medical care to patients," Wilson said. "AB 162 will help us avoid government excess and duplication, and free both physicians and government to do their jobs." Under current law, both departments must conduct their own audits, which proponents of the bill say wastes staff time and public resources. The California Medical Association supports the measure, contending that patient confidentiality faces a greater risk when multiple entities conduct audits of the same doctor's office (Wilson release, 9/21).

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